Dissociation as a mediator of psychopathology among sexually abused children and adolescents

Objective: This study investigated the role of dissociation as a mediator o f mental health outcomes in children with a history of sexual abuse. Method: The study group consisted of 114 children and adolescents (ages 10- 18 years) who were wards of the Illinois Department of Children and Family Services and were living in residential treatment centers. Interviews, prov ider ratings, and chart reviews were used to assess the relationship of chi ldhood abuse history, dissociative responses, and psychopathology. Results: Sexual abuse history was significantly associated with dissociatio n, whereas a history of physical abuse was not. Both sexual abuse and disso ciation were independently associated with several indicators of mental hea lth disturbance, including risk-taking behavior (suicidality, self-mutilati on, and sexual aggression). Severity of sexual abuse was not associated wit h dissociation or psychopathology. Analysis of covariance indicated that di ssociation had an important mediating role between sexual abuse and psychia tric disturbance. These results were replicated across several assessment s ources and varied perspectives. Conclusions: The findings suggest a unique relationship between sexual abus e and dissociation. Dissociation may be a critical mediator of psychiatric symptoms and risk-taking behavior among sexually abused children. The asses sment of dissociation among children may be an important aspect of treatmen t.